Patient Access Representative

Kids Are Our Everything.

Department: 10113 Patient Access UMC

This position reports to the Patient Access Supervisor or Manager.

It provides patient services and administrative support in ancillary operations, interacting with parents, patients, physicians, and other staff under moderate supervision in a courteous manner.

The role assists other employees within the department and across the hospital, collects and verifies demographic information for accuracy, notifies patients of scheduled and unscheduled services per insurance requirements, schedules patients for ancillary appointments, and may float to ancillary patient access areas for coverage (ED, RAD, LAB, AMSAC, etc.).

The next step in the career ladder is Senior Patient Access Rep.

• Minimum Education
• High School Diploma or GED (Required)
• Minimum Work Experience
• 2 years Related experience (Required)
• Required Skills/Knowledge

Broad knowledge of administrative processes and customer service skills. Computer knowledge necessary. Microsoft Office experience (Word & Excel) preferred.

Complete Patient Access training curriculum and pass all competency assessments. Ability to type a minimum of 35 words per minute required.

• Functional Accountabilities
• Patient Services
• Demonstrate accuracy of scheduling patients using the applicable scheduling system.

Verify charge codes correspond with diagnostic codes and enter information into billing/registration system.

• Complete computer-aided online registration screen with parent/guardian via telephone or in person in a professional and courteous manner.
• Collect accurate demographic and insurance information, update systems as needed, and complete bedside registration for ED patients.
• Reschedule appointments for patients who did not show or cancel ancillary services. Schedule follow-up appointments at checkout if applicable.
• Greet patients and parents courteously and arrange patient arrival in appropriate system based on department policy.
• Obtain required consents for the department, distribute compliance materials (HIPPA Privacy Notice, Patient Rights), and obtain copies of insurance cards and photo IDs for medical records.

Ensure appropriate copies are sent to the insurance company and the CNMC HIM department.

• Respond to patient portal work lists, including appointment requests, fax queues, email requests, and may include messaging center work lists in the future.
• Information Verification
• Verify insurance eligibility using applicable systems and adhere to managed care carve-outs (lab and radiology).
• Advise leadership of any authorization issues at check-in and contact providers to address issues promptly.
• Notify parents of the need for completed insurance referral or pre‑authorization prior to appointments.
• Discuss co‑payment, deposits, payment in full or past due balance collections with parents in a professional manner.
• Counsel parents or refer them to the Financial Information Center (FIC) for establishing payment plans.
• Ensure insurance information is complete before procedures and collect pre‑authorization/referral information, aiming for authorizations 5 days in advance of service.
• Use all patient information systems (EPRS, SCI, Cerner, IDX, Mc Kesson, etc.) to keep data synchronized.
• Cash Collection
• Collect and record co-payments, deposits, and payments in full, provide payer receipts, and help the department meet its 85% collection target.
• Maintain departmental requirements regarding cash controls and collections.
• Billing Preparation
• For ancillary services, ensure all orders/scripts/referrals are obtained before services are rendered.
• Appropriately clear walk-in patients and link scheduled/unscheduled appointments to the scheduling system.
• Ensure daily quality review of all registration processed in real time.
• Office Support
• Answer telephone calls and address caller needs appropriately, avoid unnecessary transfers, and meet department ACD standards.
• Manage voicemail messages within the same business day.
• Distribute mail and return mail as needed.
• Check work e‑mail at least three times daily and respond within 24 hours (or next business day).
• Maintain office files and supplies at appropriate levels.
• Keep the reception area and work space clean.
• Provide additional support as needed.

Benefits That Support You

• Comprehensive health coverage, including medical, prescription, infertility, and transgender health services.
• Generous paid time off, including vacation accrual from day one, sick leave, holidays, and a personal day.
• Financial wellness support, including a 401(k) plan and healthcare and dependent care spending accounts.
• Employer‑paid life, AD&D, and long‑term disability coverage, with optional supplemental plans.
• Additional perks, including tuition assistance, fitness resources, employee assistance, commuter benefits, and more.
• Why Join Us
• Nationally Recognized Excellence – consistently ranked among the Top 10 Children’s Hospitals by U. S. News & World Report.
• Leading Pediatric Care – a large, comprehensive children’s hospital offering nationally ranked specialties and cutting‑edge treatments.
• Innovation & Research – a premier academic medical center committed to pediatric research, education, and advancing child health.
• Mission‑Driven Culture – a family‑centered care environment fostering collaboration and support among clinical teams.

The disclosed salary range includes the minimum and maximum rates within which Children’s National believes an individual’s base pay rate will fall for this position.

The exact pay rate will be based on factors in alignment with Children’s National compensation philosophy and does not include our comprehensive benefits package or other compensable items.

Children’s National Hospital is an equal‑opportunity employer that evaluates qualified applicants without regard to race, color, national origin, religion, sex, age, marital status, disability, veteran status, sexual orientation, gender identity, or other protected characteristics.

Our policy ensures a “drug‑free” work environment, prohibiting the illegal use, possession, or distribution of controlled substances and misconduct involving legal substances.

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